Cholera

What is cholera?

Cholera is an illness caused by infection of the intestine with the vibrio cholerae bacteria.

Infection may cause severe diarrhoea and, as a result, dehydration. It’s most often found in parts of the world with poor quality water and sanitation.

What are the symptoms of cholera?

Symptoms of cholera include:

• sudden watery diarrhoea
• vomiting

Some people don’t have any symptoms or only have mild diarrhoea. Their faeces (poo) can still infect other people.

Symptoms can appear within a few hours to up to 5 days after infection with the bacteria.

About 1 in 20 people have a severe (bad) cholera infection.

If your infection is bad, you can become severely dehydrated and may die if not treated.

Symptoms of a severe cholera infection are:

• lots of painless watery diarrhoea
• vomiting

This can lead to:

• hypotension (low blood pressure)
• dry mouth
• being very thirsty
• muscle cramps

What causes cholera?

Cholera is caused by infection with the vibrio cholerae bacteria.

You can get cholera from drinking water or eating food that has been contaminated with the bacteria.

Cholera is also spread by contact with the faeces (poo) of an infected person.

The illness can spread rapidly particularly in areas with:

• unsafe drinking water
• poor sanitation
• inadequate hygiene

Where is cholera found?

Cholera is found in countries with limited access to clean drinking water and poor sanitation.

Cholera is found in more than 50 developing countries, mainly in:

• Africa
• South Asia
• Southeast Asia

The risk is higher in urban slums and camps for displaced people.

Almost all cases in Australia happen in people who were infected while overseas.

When should I see my doctor?

If not treated, cholera can be fatal (cause death). It’s important to speak to your doctor if you have cholera symptoms.

How is cholera diagnosed?

Cholera is diagnosed by testing a sample of your faeces (poo).

How is cholera treated?

The main treatment for cholera is oral rehydration therapy to replace fluid and salts lost through diarrhoea. When travelling, you should carry oral rehydration solution. You can buy this in small sachets from your pharmacy.

People with severe dehydration will need intravenous fluids given through a drip.

Sometimes people with cholera may be given antibiotics. Antibiotics can reduce the length and severity of the illness.

Cholera can be fatal if not treated.

Can cholera be prevented?

To avoid cholera when travelling, always eat and drink safe food and water.

Safe food choices are:

• fruit you can peel
• cooked foods
• bottled water

Assume that all water and ice is contaminated. If you can’t get bottled water, then sterilise your water by:

• boiling it for at least 5 minutes
• using water purification tablets

Wash your hands with soap and running water (or use hand sanitiser):

• before handling food
• before you eat
• after using the toilet

You should avoid:

• raw or undercooked meat and seafood
• food and drinks from street vendors
• raw fruits and vegetables (including salads)
• any foods contaminated by flies or dirty hands

Cholera vaccination

Vaccination against cholera isn’t generally recommended. It should be considered for people at increased risk of diarrhoeal disease, such as people with:

• poorly controlled diabetes
• inflammatory bowel disease
• HIV/AIDS
• impaired immunity
• significant cardiovascular disease

Vaccination is not needed for entry into any foreign country.

Complications of cholera

Cholera can lead to severe dehydration.

Death is rare — less than 1 in 100 people die if they get prompt medical care.